title: All-cause and disease-related health care costs associated with recurrent venous thromboembolism.
abstract: It was the objective of this study to quantify the risk of complications and the incremental health care costs associated with recurrent VTE events. Health care insurance claims from the Ingenix IMPACT database from 01/2004-09/2008 were analysed. Subjects aged ≥18 years on the date of first recurrent VTE diagnosis with ≥12 months of baseline observation prior to the index recurrent VTE were matched 1:1 with no-recurrent VTE patients based on propensity scores. The risk of developing post-thrombotic syndrome (PTS) and other disease-related diagnoses (thrombocytopenia, superficial venous thrombosis, venous ulcer, pulmonary hypertension, stasis dermatitis, and venous insufficiency) was compared between the recurrent and no-recurrent VTE groups for up to one year. All-cause and disease-related costs per patient per year (PPPY) were calculated. The recurrent VTE and no-recurrent VTE cohorts (8,001 subjects in each group) were matched with respect to age, gender, and comorbidities. The risk ratios (RRs) indicated that the risk of developing post-event complications was significantly higher for the recurrent VTE group compared to the no-recurrent VTE group (RR [95% CI]: PTS: 2.7 [2.4 - 2.9], p-value <0.01). Patients with recurrent VTE had significantly higher average PPPY all-cause costs compared to no-recurrent VTE patients ($86,744 versus $37,525, cost difference: $49,219 [€33,617]; 95% CI= 46,253-51,989). Corresponding disease-related health care costs PPPY were also significantly higher for the recurrent VTE group ($11,120 vs $1,262, cost difference: $9,858 [€6,733]; 95% CI= $9,081-$10,476). In conclusion, in this large matched-cohort study, recurrent VTE patients had significantly higher risk of complications and health care costs compared to no-recurrent VTE patients.
authors.affiliation: François Laliberté, Senior Economist, Groupe d'analyse, Ltée, 1000 rue de la Gauchetière Ouest, Bureau 1200, Montréal, Québec H3B 4W5, Canada, Tel.: +1 514 394 4488, Fax: +1 514 394 4461, E-mail: flaliberte@analysisgroup.com.
authors.forename: Patrick
authors.initials: P
authors.lastname: Lefebvre
authors.forename: François
authors.initials: F
authors.lastname: Laliberté
authors.forename: Edith A
authors.initials: EA
authors.lastname: Nutescu
authors.forename: Mei Sheng
authors.initials: MS
authors.lastname: Duh
authors.forename: Joyce
authors.initials: J
authors.lastname: LaMori
authors.forename: Brahim K
authors.initials: BK
authors.lastname: Bookhart
authors.forename: William H
authors.initials: WH
authors.lastname: Olson
authors.forename: Katherine
authors.initials: K
authors.lastname: Dea
authors.forename: Yvonnick
authors.initials: Y
authors.lastname: Hossou
authors.forename: Jeff
authors.initials: J
authors.lastname: Schein
authors.forename: Scott
authors.initials: S
authors.lastname: Kaatz
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012306:Risk; D014481:United States; D054556:Venous Thromboembolism / Q000191:economics* / Q000453:epidemiology*
keywords: Recurrent venous thromboembolism; complications; costs; risks